Not Yet Rated
New Course
1 Hour (On-Demand)
CPE Not Available
Instructor for this course
more
To Access This Course:

This course explains how insurers, insurance adjusters, and insurance special investigation unit investigators work to prevent insurance fraud (obtaining funds from an insurer wrongfully and illicitly). It explains staged losses, fake thefts, paper property, arson for profit, false documentation, and other efforts to defraud an insurer.  The course also explains what is necessary to prove fraud as a defense to an insurance claim. 

The course covers the following:

  1. The use of investigators to gather evidence establishing that a fraud is being attempted.
  2. The various types of fraud attempted against first party property policies.
  3. Understanding the staged accident.
  4. Understanding the use of paper property.
  5. How to discover an arson for profit.
  6. How to prove that an insured is involved in an arson for profit.
  7. How to discover health insurance fraud.
  8. How to recognize professional conspiracies.
  9. How to recognize fraud in the legal profession.
  10. How to act in good faith and fair dealing with regard to insurance fraud.

Learning Objectives

  • Explore how the fraud perpetrator’s use of the covenant of good faith and fair dealing to defeat insurer’s claim of attempted insurance fraud.
  • Recognize the elements insurance fraud and the proof needed to assert fraud as a defense.
  • Identify what investigation will be performed to stop fraud.
  • Explore how the statutory requirement to thoroughly investigate potential fraud makes successful fraud difficult.

 

 

 

Included In Certifications

This course is included in the following Expert Certifications:

16 CoursesCertified Expert in Corporate Property Insurance

  1. Introduction: Excellence in Claims Handling
  2. How to Acquire a First-Party Property Insurance Policy
  3. How to Read and Understand an Insurance Policy
  4. The Necessity of an Honest and Complete Insurance Application
  5. The Law of Contracts for the Insurance Professional
  6. Ethics for the Insurance Professional
  7. What is the Problem with Fraud?
  8. Interviewing Techniques for the Insurance Professional
  9. Investigation of a First-Party Property Insurance Claim
  10. The Creation of a Scope, Statement, and Proof of Loss
  11. The Duties of an Insured Presenting a First-Party Property Claim
  12. The Insurance Examination under Oath (EUO)
  13. Insurance Fraud Prevention
  14. Compliance with Special Investigation Unit Regulations
  15. Compliance with Good Faith Settlement Practices Regulations
  16. The Obligations of a Public Insurance Adjuster

Prerequisites

Course Complexity: Intermediate

No Advanced Preparation or Prerequisites are not needed for this course. However, it is recommended to take the other courses in the series prior to completing this one.

Education Provider Information

Company:
Illumeo, Inc., 75 East Santa Clara St., Suite 1215, San Jose, CA 95113
Contact:
For more information regarding this course, including complaint and cancellation policies, please contact our offices at (408) 400- 3993 ext. 106, or send an e-mail to .
Course Syllabus
INTRODUCTION AND OVERVIEW
  10:33Introduction to Insurance Fraud Prevention
  10:54Types of Insurance Fraud
  1:38Insurance Claims Handling and Insurance Fraud
  2:08The Covenant of Good Faith & Fair Dealing and Its Effect on Insurance Fraud Investigations
  10:48When Insurance Fraud is Suspected in a First Party Property Claim
  10:34The First Party Property Claim and Insurance Fraud
  9:05The First Party Property Claim
  4:35The Philosophy of Denial of a Fraudulent Claim
CONTINUOUS PLAY
  1:00:15Insurance Fraud Prevention
SUPPORTING MATERIALS
  PDFSlides: Insurance Fraud Prevention
  PDFInsurance Fraud Prevention Glossary
REVIEW AND TEST
  quizREVIEW QUESTIONS
 examFINAL EXAM